Hospitals — Infrastructure Investor

Interactive model

Social Infrastructure · Hospitals

What pays for a hospital — and how stable it is

An NHS hospital PFI splits the asset from the care: the investor funds the building and maintains it, and is paid a long, government-backed, inflation-linked unitary charge for availability and hard FM — paid whether or not every bed is full — while the clinical services stay public. On top sits the soft FM (cleaning, catering, portering) and car-park income that flex with how busy the hospital is. The availability charge is the rock-solid core; activity adds a services kicker. The case turns on the size of the estate, the charge, and bed occupancy.

Beds800

Unitary £/bed£75k

Bed occupancy90%

LIVE

Occupied ward patient in — soft FM in use Available bed funded whether filled or not Soft FM & car park cleaning, catering, parking Unitary charge paid at the main entrance

Flows — annualised from current assumptionsper year

Revenue p.a.

£0

£0 / hr

EBITDA p.a.

£0

0% margin

Revenue / bed

£0

unitary + services

Beds occupied

90% occupancy

Stocks — what the flows accumulate intolive

Beds occupied now

of 800 beds

EBITDA banked · session

£0

accumulating in real time

Implied enterprise value

£0

at 16× EBITDA

Where revenue comes from Total £0 p.a.

Availability & hard FM

Soft FM & car park

Why investors like hospital PFI: the unitary charge is one of the longest, largest and most secure income streams in infrastructure — a 25–35 year, sovereign-backed, inflation-linked annuity for the availability of the building, paid by the NHS regardless of how many beds are full. That contracted core supports very high leverage and low, stable equity returns. The soft-FM and car-park layer flexes with hospital activity, adding a modest kicker. The real risks are operational — availability and FM-performance deductions — not demand.

Revenue streams£0 p.a.

Operating costs£0 p.a.

Investment case — should you buy it?DCF returns

Year-1 financials flow live from the simulation above: revenue £0 and EBITDA £0 p.a. Set your deal terms below — the unlevered IRR (asset return) and levered IRR (return to equity, after debt) recompute instantly.

Operating

Revenue growth p.a.%

OpEx vs base%

Cost inflation p.a.%

Lifecycle capex%

Depreciation%

Tax rate%

Valuation & hold

Entry EV / EBITDA×

Exit EV / EBITDA×

Hold periody

Financing

Leverage (Net debt / EBITDA)×

Cost of debt%

Debt amortisation p.a.%

Unlevered IRR

—

asset / project return

Levered IRR

—

return to equity

Equity multiple

—

MOIC over hold

Equity gain

—

exit equity − invested

Equity cash-flow profile£m · ■ invested ■ returned

Projection — £m per year

Illustrative model. Represents an availability-based NHS hospital PFI/PPP. Revenue = a contracted unitary charge for availability & hard FM (beds × charge, paid regardless of occupancy) plus soft-FM services (cleaning, catering, portering) and car-park/retail income that scale with bed occupancy. Operating costs (hard FM & lifecycle, soft-FM staffing, energy & utilities, insurance & SPV, a management fee) are part fixed (per bed) and part activity-driven — so the unitary annuity is a stable high-margin core while soft-FM revenue and cost flex together. Clinical services are provided separately by the NHS and are not part of this model. EBITDA = revenue − operating costs; excludes upfront construction capex and senior debt service. The investment case is a simplified DCF. For illustration only — not investment advice, and not any specific asset.